Wednesday, 24 August 2016

TWO MONTHS
The monkey on my back is no longer a mandrill, more of a vervet.

I still want to smoke, sometimes A LOT, but it’s slowly becoming more an emotional and mental need, a kind of nostalgia. I miss it like Wendy missing Neverland.

For the first time, smoke smells bad to me. A friend was smoking Rothmans, admittedly one of the stinkiest fags, and I didn’t like it. Up until now, I’ve stood next to friends while they smoked and even followed people in the street a couple of times (yes, I know).

The IBS has mostly calmed down. For the first month, my digestion was seriously messed up and sometimes I looked five months pregnant, not because of the stress of quitting but because of physical withdrawal from chemicals that have controlled appetite and digestion for over 30 years. It takes a while for that to normalise (and it pisses me off when people assume IBS is caused solely by stress and, by implication, that I’m a feeble, neurotic woman).

The weight gain is holding steady at around 3kg. I’m exercising like buggery to get rid of it but so far, no dice. I haven’t noticed any difference at the gym with the weights but I can go harder on the cardio and being really out of breath at the end feels good, an endorphin rush I haven’t had for years. My knees aren’t so keen though.

I spoke to my dentist about whether the inhalator is having an effect on my oral health and he said that as long as my mouth isn’t permanently dry, it should be OK long term. On the upside, circulation to my gums is greatly improved already. On the downside, the fast recovery means they are much more sensitive so a session with the hygienist was nasty even with painkilling gel.

I’ve discovered that when someone kisses you, they can’t taste the nicotine from the inhalator, so that’s a bonus.

I’ve noticed that inhalators are sold in the pharmacy section of my supermarket whereas vaping equipment is sold with smoking products.

The rage has mostly gone although there are still moments. I haven’t done anyone actual harm but I’ve come very close a couple of times. They deserved it. I can now see the appeal of being a vigilante superhero – judge, jury and executioner. I may have to work on that. Or buy a cape and mask.

Things not to say 1: If I say I want to smoke, don’t say ‘No you don’t’ and think you’re being helpful because I really do. Acknowledge the craving and help me deal with it by distracting me – make me laugh, do a little dance, whatever.

Things not to say 2: ‘What, still?’ Yes, still. Just because smoking doesn’t cause extreme and obvious behavioural changes like some drugs and alcohol can doesn’t make it any less powerful an addiction. I’m bored with it too, with how much attention it takes up - even when I’m thinking about something else at the same time. I want it to be over and done with. So kindly take your short attention span elsewhere.

Things not to say (or think) 3: Stop making a fuss and get on with it, you shouldn’t have been smoking in the first place. There’s a moral judgement attached to some people’s response to addiction, even if they don’t admit it. It’s based on ignorance about genetics, personality, environment, whether the people you most closely identified with did it, changing social acceptance, legality, and smugness. A lot of smugness. No one factor makes anyone a victim destined to be an addict but it’s a complex, multi-factorial thing and judging from your moral high ground really doesn’t help.

THREE MONTHS
The vervet has shrunk to a pygmy marmoset. I’ve decided to give her a name – Sparky. ***

Do I still want to smoke? Yes, every day, mostly in the evenings. But not for as long or as intensely as before, and it’s not making me miserable that I can’t.

I’m having regular dreams where I light up, then realise what I’ve done and wake up really angry with myself, so it looks like my unconscious is rooting for me too. Shame it can’t have a word with my metabolism.

From a 3kg peak, weight gain is now 1.5kg. I’m eating a bit less than I was before I quit but there really wasn’t much I could trim off my diet and now I’m hungry a lot of the time, which is miserable. The Nicotine Replacement Therapy is supposed to help with metabolism, hunger and weight gain. Maybe I’d have gained a lot more without it, there’s no way of knowing.

Public health and other advice websites assume that all smokers are fat bone-idle slugs so their weight gain advice is mostly just to be more active and avoid snacking, which is no use to me at all.

I’m trying HIIT as part of my regular workout (High Intensity Interval Training – basically doing sprints). There are many variations and I’m doing a 2:1 ratio: 20 second sprints then 10 seconds slower on the bike, repeated for four minutes, at the end of every workout (two weights, two cardio per week) plus an extra cardio session with HIIT, plus a lot of walking. Research shows HIIT is better for weight loss than longer periods of less intense cardio. I don’t know if I’ll be able to go back to my normal gym routine once I’ve lost the weight or if I’ll have to keep up this level of intensity forever to keep it off. I bloody hope not. I’ve had knee problems since I was a kid and compartment syndrome in both legs about six years ago so I don’t want to push my luck. My knees hate me right now.

Things I have learned 1: Nicotine is the third most addictive substance known, after heroine and cocaine, then alcohol and barbiturates. There is also an individual factor that makes some people more susceptible to some substances than others - I’ve used four out of those five and only become addicted to one.

Things I have learned 2: Smokers tend to have more visceral fat – the one that sits round the organs and causes serious health problems. It’s a stealth fat that even people who don’t look overweight can have. Because of chemical changes in the body, weight-gain after quitting is more likely to be subcutaneous fat (under the skin), which is less harmful, especially short-term. And it will be short term, if it kills me.

Things I have learned 3: Nicotine is not all bad. This shouldn’t be a surprise as poisonous plants like deadly nightshade have medical uses.

It has been found to protect against Parkinson’s disease. A small study has found that it may also protect against the early stages of Alzheimer’s disease.

There isn’t even much of a problem with addiction in its therapeutic use because, according to an article in Scientific American, other ingredients in tobacco smoke are necessary to amp up nicotine’s addictiveness. Those other chemical ingredients—things like acetaldehyde, anabasine, nornicotine, anatabine, cotinine, and myosmine—help to keep people hooked on tobacco. On its own, nicotine isn’t enough.

Another benefit is as a cognitive enhancer. According to Jennifer Rusted, professor of experimental psychology at Sussex University: “To my knowledge, nicotine is the most reliable cognitive enhancer that we currently have, bizarrely.” Many other studies back her up.

According to another article in Scientific American: Psychologists and tobacco-addiction specialists think it's now time to distinguish clearly between nicotine and smoking; the evidence shows smoking is the killer, not nicotine.

"We need to de-demonize nicotine," said Ann McNeill, professor of tobacco addiction at the Institute of Psychiatry, Psychology and Neuroscience at King's College London.

Things I have learned 4: There’s a lot of disagreement over whether addiction is a disease or a learned pattern of behaviour, whether addicts are helpless victims and should be treated as such or whether this view disempowers people and makes them less likely to try to take control and change. The term ‘brain plasticity’ gets bandied about a lot in terms of learning or unlearning behaviour, including addictive behaviour, but it’s pretty much empty of meaning and should be regarded with skeptical caution.

What next?
This is the point where I should think about stopping the NRT according to some guidance but I’m in no rush. One Everest at a time. And according to the research I’ve mentioned, it’s not doing me any lasting harm and may even have some benefits.

For the first time since I was a teenager I will have to deal with life’s vicissitudes without the comfort blanket of nicotine, which could be interesting. But Sparky and I will keep plodding down the long and winding road. Maybe I can train her to wear a little hat and bang cymbals.

** That's English fags, not American fags, obviously.
*** Monkey notes: the mandrill is the largest monkey, the pygmy marmoset the smallest and the vervet (not surprisingly) somewhere in between.

SIX MONTH UPDATE

Still not smoking. Still wanting to smoke or at least wanting the comfort of it. Still using the inhalator. Still haven’t lost all the weight.

For the last two months I’ve been constantly ill with colds, laryngitis, three day flu (despite having the jab), more colds. There are endless forums where quitters talk about how many times they’ve been ill since stopping. None of the public health advice sites warn you that the immune system can take a long time to recalibrate itself and, while it does, you’re vulnerable to every passing invader. Also, nerve cells in the respiratory tract are beginning to work normally again, which means you’ll feel pain and irritation that smoking damped down, and the cilia take time to regrow to help repel the invaders.

It really does feel like a kind of penance. I would very much appreciate it if everyone would just stop breathing on me.

SEVEN MONTHS

I seem to have emerged from the tunnel of germs. My knees no longer hate me and have adjusted to the extra cardio, and I've lost two of the three kilos I gained.

I've had some very difficult personal stuff to deal with, including a funeral and my first response was to reach for a cigarette. An actual physical reach for a pack that wasn't there. Someone said that it would be understandable and not a failure if I just had one, if that helped me cope. I explained that I can't just have one. Ever.

2016 was probably not the best year to quit, given what's been happening in my world. But then, there never is a best year. If not now - when?

NINE MONTHS
More colds and viruses. I may not live any longer now but it sure as hell will feel like it. I need a way to surround myself with a cloud of smoke to keep the germs at bay without doing myself harm. Basically, I need to become a dragon.

Still haven't lost the extra weight, damn it.

And yes, I do still have nostalgia pangs for smoking, especially the lighting up part. But not nearly as often and the smugness helps keep them to a minimum, especially as the cost of a pack has now gone up to over £10.

One of my younger relatives told me that of the ten people on his course, he's the only one who doesn't vape. Not one of them were previously smokers. That's a worrying trend even if they never move onto cigarettes as there is increasing evidence of harm. Tobacco companies are aiming to double their vaping sales as fewer and fewer adults smoke. Profit has to come from somewhere and young people are a prime target because they think they'll live forever whatever they do.

Some smokers I know are starting to get defensive around me, which can be difficult. "I know I should give up, but ...". I'm not making you feel bad, that's all on you. I know you'd feel better if I started again but I won't. Sorry about that.

About Me

Hello, gentle reader.
I write mostly about skeptical and (roughly) scientific matters, often health, gender and sex related.
I run London Skeptics in the Pub and I have a PhD in something you will never need to know about.
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